Idiopathic pulmonary fibrosis

TE King, A Pardo, M Selman - The Lancet, 2011 - thelancet.com
The Lancet, 2011thelancet.com
Idiopathic pulmonary fibrosis is a devastating, age-related lung disease of unknown cause
that has few treatment options. This disease was once thought to be a chronic inflammatory
process, but current evidence indicates that the fibrotic response is driven by abnormally
activated alveolar epithelial cells (AECs). These cells produce mediators that induce the
formation of fibroblast and myofibroblast foci through the proliferation of resident
mesenchymal cells, attraction of circulating fibrocytes, and stimulation of the epithelial to …
Summary
Idiopathic pulmonary fibrosis is a devastating, age-related lung disease of unknown cause that has few treatment options. This disease was once thought to be a chronic inflammatory process, but current evidence indicates that the fibrotic response is driven by abnormally activated alveolar epithelial cells (AECs). These cells produce mediators that induce the formation of fibroblast and myofibroblast foci through the proliferation of resident mesenchymal cells, attraction of circulating fibrocytes, and stimulation of the epithelial to mesenchymal transition. The fibroblast and myofibroblast foci secrete excessive amounts of extracellular matrix, mainly collagens, resulting in scarring and destruction of the lung architecture. The mechanisms that link idiopathic pulmonary fibrosis with ageing and aberrant epithelial activation are unknown; evidence suggests that the abnormal recapitulation of developmental pathways and epigenetic changes have a role. In this Seminar, we review recent data on the clinical course, therapeutic options, and underlying mechanisms thought to be involved in the pathogenesis of idiopathic pulmonary fibrosis.
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